Guild of Nurses: a present from the past for the future

This article was written by Professor Lisa Bayliss-Pratt, Chief Nurse, Health Education England in her series identifying inspirational nurses.  Guild news is re-printing her publication.

Guilds have been around since the 12th century, but until now never one for the nursing profession. Brenda Griffiths, one of the inspirational nurses I have had the privilege of meeting this year, is inspiring not only because of her long and dedicated service to health and health care, but because she has been instrumental in setting up a Guild of Nurses in the City of London - a first step to creating a Livery Company for Nurses.

Brenda first suggested founding a Guild of Nurses at a reunion with a group of nursing colleagues about three years ago - all of whom had trained together at Bart's in the 1970s and who had seen the valuable work of the Livery Companies in action.

The idea that nurses should be included amongst the noble professions represented in the Livery world was something Brenda had been mulling over. 'I thought the Livery movement was an obvious way of promoting nursing as a profession, safeguarding standards and bequeathing a legacy to nursing that would live well beyond today's members,' she explains.

Port and the Loving Cup

Brenda had been fortunate enough to find about the Livery movement at the very start of her nursing journey as an18 year old student nurse at Bart's in the 1970s. 'After winning a proficiency prize in my first year, sponsored by the Clothworkers Company,' she says, 'I was invited to a very formal Livery dinner - the kind where you are expected to pass the port and the Loving Cup – a unique experience for a young trainee and one I will never forget.’

Part of the modern world, not just history

'It isn't just history and ceremony and enhancing and protecting medieval crafts and trades though!' she says. 'The City of London Livery Companies are very much part of the modern world, and support many initiatives through awards, prizes and funding the development of better facilities for education and training and offering benevolent support to those in need.

'Many nursing organisations face financial challenges - especially where funding is tied to specific nurse training or to a single School of Nursing or hospital. When nurse education moved to universities, students' allegiance became more aligned to the university alumni rather than the hospital of their clinical placements; in this way, funds may get absorbed into other charities and are lost to nursing.

A safe repository for donations

The Guild’s associated charity can offer a safe repository for such funds and ensure that charitable donations are ring-fenced for their original purpose – a way of securing earmarked funding to keep them within the nursing profession. An important factor is that a Guild of Nurses is non-controversial, non-partisan, fully inclusive with no specific political position as an organisation.'

Our members - who can come from any specialty - have an opinion on everything and you can hear very passionate debates at our events.

And the third strong motivator to setting up such a Guild was a desire to ensure that nurses of today and tomorrow enjoy the very high standard of training and support that the Founders - Brenda and her colleagues - enjoyed at Bart's. 'I broached the idea to them and they all said 'Let's do it.' We decided to explore whether the profession would be interested in a Guild of Nurses and if the City would welcome the idea.' 'The answer was an unequivocal yes,' Brenda explains. 'In fact, people said to us - this seems obvious now you've suggested it and we can't think why it's not been done before.'

'The obvious answer of course is - we've been too busy working!'

And the obvious riposte to that is the well-known adage: 'If you want something done, ask a busy woman.'

The birth of the Guild of Nurses

So from a bright idea to a solid reality has been a matter of just three years thanks to the hard work and tenacity of Brenda (whose official title at the Guild is Founder Warden and Foundation Past Master) and her seven colleagues. All Livery Companies have a common purpose: to enhance the professional knowledge of their members, to fund and support charitable and benevolent causes; and to support the Lord Mayor and the City of London Corporation. (Brenda, above, with the Guild Nurses' Lamp.)

With this in mind, the first step was to ensure that there was an appetite within the profession. Brenda says, 'Initially, we did wonder if anyone would want to join us! We then needed to ask the City if they would support our application’. It was essential to identify a Sponsoring Alderman who would champion the cause and guide the application through the process, overseen by the Court of Aldermen. Brenda approached Sir John Chalstry for advice.

A lasting legacy for nurses

An eminent Bart's surgeon, Sir John was Lord Mayor of London in 1996 who suggested they ask Alderman Dr Sir Andrew Parmley (Lord Mayor 2017-18) if he would be willing to support us. 'And he was.' Brenda explains. 'He is a wonderful, most charming and helpful asset guiding our application’. There are stages and targets that need to be met as a new Guild, and then further targets to progress to Company without Livery after four years, Livery Company in another four years and then application for a royal charter.

'It is a lengthy process which will take about 10 years, but will be a lasting legacy for nurses in generations to come.’

Why nursing rather than medicine?

Apart from setting up the Guild, Brenda has had a long and dedicated career in our profession, so I asked her what brought her into nursing. 'I can't remember a time when I didn't want to be a nurse.' Brenda says. With a doctor and nurse as parents, it was likely she would have chosen a career in health care, but why nursing rather than medicine?

'I knew I would be better as a nurse. I felt more drawn to helping people feel and get better - it seemed to me that medicine was more about diagnosis and having less time with the patient.

'The professions are parallel in that both want to make the patient better, but we achieve those outcomes in different ways.'

Brenda began her nurse training in 1974 at Bart's (pictured, right, as a ward sister) which she reflects now was a very protected environment. 'It was good for me as an 18 year old straight from school. Students lived in the nurses' home and the training we had was second to none. It was like an apprenticeship, learning from very impressive people - mostly women - who had dedicated their lives to their patients and the health service and were fantastic role models.

They watched every step and when they knew you had mastered a procedure they let you get on with it. This high level of trust meant you might be left in charge of a 24-patient ward at night in the second year of training, but help was only a bleep away. So by the time you became a staff nurse you had already had management experience. Living and working together like this, student nurses developed a camaraderie, friendships and a peer support group and formed strong bonds which have lasted all our lives.

Changes and challenges facing nursing now

Our profession is evolving hugely and facing some major challenges, including leaving the EU and the pressure that may put on the workforce, changes in education and funding, new roles and of course, demographic changes,' Brenda says.

'But although the context in which nurses are working is changing so much, the reasons we go into nursing haven't changed. Nurses want to contribute to people's health and well being and the patient must be the focus.

The reasons we go into nursing haven't changed. Nurses want to contribute to people's health and well being and the patient must be the focus.

There is more of a theoretical basis to training today, and nurse learners are not an integral part of the workforce, so the reality of life in the modern NHS can hit people hard when they first qualify.

'When I was a student, patients stayed in hospital longer so we saw them going through the recovery process. And we would then sometimes book them into a convalescent home on the coast to complete their recovery. In the 1970s at Bart's, many patients I saw as a student came from the surrounding deprived, inner London borough and many had poor housing without an indoor bathroom, so this kind of support was very welcome. A facility completely unknown today but that made a huge contribution to the prevention of early re-admission.

'Today, patients go home more quickly and it's family and carers who see them through their recovery. I think this means that the nursing team in the acute sector doesn't always see the full effects of the intervention or treatment, and that's a real change.'

Valuable insights for today from yesterday's experience

That early experience of seeing patients through the recovery process has provided valuable insights for Brenda's role now, as a non-executive director at Hertfordshire Community Trust (pictured below). Part of her work is to look strategically at patient flows, including preventing unnecessary admissions to hospital, preventing the 'revolving door' syndrome and supporting people at home.

However, the co-ordination between health, social care and other agencies continues to be a real challenge. 'It does seem to me sometimes that we need to act as obstacle removers' she says. 'We've been saying it for years, and it still needs saying, that we need to work hard with our partners to eradicate silo working between hospital, community and adult social care. That is a major challenge for all health care providers today.'

It does seem to me sometimes that we need to act as obstacle removers

What advice would you give to someone thinking of becoming a nurse now? I asked

'It's the greatest profession in the world as long as you have an interest in people and want to contribute both to society, community and individuals' health and well being,' Brenda says. 'Nursing opens an entire world to you. Your training and experience as a nurse give you a great insight into working with and for others, team working, practical and organisational skills - all of these are transferable into completely different realms of life.

'For example, If you had told me at 18 that I would go into policing, for example, {Brenda was appointed as an Independent Member of Hertfordshire Police Authority in 2003} I would have laughed, but it is simply another public sector body trying to deliver good services.

If you want an easy life nursing is not for you, but I would challenge anyone to find anything more rewarding or which allows you to give more back to your community.

If you want an easy life nursing is not for you, but I would challenge anyone to find anything more rewarding or which allows you to give more back to your community.

If you want an easy life nursing is not for you, but I would challenge anyone to find anything more rewarding or which allows you to give more back to your community. And it's not a one way street - we both benefit. Nurses are with people at critical times in their lives, when we see humanity at its very best and very worst. And what a privilege it is to be there with someone at the beginning or end of their life and to share the many stages in between.

'To help someone to a good death or to bring a new life safely into the world is a value beyond measure.'